Provider Demographics
NPI:1851571020
Name:MADANAT, JOHN PAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:PAUL
Last Name:MADANAT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:RAOUF
Other - Middle Name:SAMEH
Other - Last Name:MADANAT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:125 WHEELER AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006-3220
Mailing Address - Country:US
Mailing Address - Phone:626-294-4866
Mailing Address - Fax:516-570-3527
Practice Address - Street 1:125 WHEELER AVE
Practice Address - Street 2:SUITE C
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91006-3220
Practice Address - Country:US
Practice Address - Phone:626-294-4866
Practice Address - Fax:516-570-3527
Is Sole Proprietor?:No
Enumeration Date:2007-11-05
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA110657208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation